20971INTRODUCTION_TO_HIV&AIDS for nursing students[1].ppt

20971INTRODUCTION_TO_HIV&AIDS for nursing students

1. HIV: THE GLOABAL AND MALAWIAN
SCENARIO
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2. Lesson objectives
•Understand the global and local impact of the epidemic
•Know about HIV/AIDS in adults, children, and families
•Understand the natural history of HIV infection
•
Understand the modes of HIV transmission
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Scope of the HIV/AIDS Pandemic
Natural History and Transmission of HIV

3. HIV
•Human Immunodeficiency Virus
•H = Infects only Human beings
•I = Immunodeficiency virus weakens the immune system and
increases the risk of infection
•V = Virus that attacks the body
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4. AIDS
•Acquired Immune Deficiency Syndrome
•A = Acquired, not inherited
•I = Weakens the Immune system
•D = Creates a Deficiency of CD4+ cells in
the immune system
•S = Syndrome, or a group of illnesses
taking place at the same time
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5. HIV and AIDS
•When the immune system becomes
weakened by HIV, the illness
progresses to AIDS
•Some blood tests, symptoms or
certain infections indicate
progression of HIV to AIDS
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6. HIV-1 and HIV-2
•• HIV-1 and HIV-2 are
• Transmitted through the same routes
• Associated with similar opportunistic infections
• HIV-1 is more common worldwide
• HIV-2 is found in West Africa, Mozambique, and
Angola
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7. HIV-1 and HIV-2
•
HIV-2 is less easily transmitted
• HIV-2 is less pathogenic
• Duration of HIV-2 infection is shorter
• MTCT is relatively rare with HIV-2
• MTCT of HIV-2 has not been reported from Malawi
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8. Transmission of HIV
•HIV is transmitted by
• Direct contact with infected blood
• Sexual contact: oral, anal, or vaginal
• Direct contact with semen or vaginal and
cervical secretions
• HIV-infected mothers to infants during
pregnancy, delivery, or breastfeeding
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9. Transmission of HIV
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HIV is not transmitted by
•
Public baths
• Handshakes
• Work or school contact
• Using telephones
• Sharing cups, glasses,
plates, or other utensils
•Coughing, sneezing
•Insect bites
•Touching, hugging
•Water, food
•Kissing

10. Global HIV/AIDS in 2004 *
•39.4 -40.0 million people are living with HIV/AIDS
•2.2 million are children under 15 years
•6,40,000 children were newly infected with HIV in 2004
•5,10,000 children died of HIV in 2
•* Source: UNAIDS,2004
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5.1 m. Indian living with HIV

11. Reported cases
•Reported AIDS cases
• (15,202)
•Estimated AIDS cases
• (219,400)
•People living with
•HIV/AIDS (2.2 million)
Only a small number of PLWHA are reported
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12. Impact of Global HIV
•Negative economic impact on countries
•Overstrained healthcare systems
•Decreasing life expectancy
•Reversal of child survival gains
•Increased numbers of orphans
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13. omero
Mode of Transmission of HIV In MALAWI

14. omero
0
10
20
30
40
50
60
70
80
90
100
# uninfected
# infected during
BF for 2 yrs
# infected during
delivery
#infants infected
during
pregnancy
63
uninfected
15
15
7
MTCT in 100 HIV+ Mothers
The majority of children do not get
infected even when we do nothing

15. Prevention of
HIV Transmission
• Strategies to prevent HIV transmission
•Personal strategies
•Public health strategies
• Safe practices: no risk of HIV transmission
• Risk reduction: reduces but does not eliminate
risk
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16. Prevention of
HIV Transmission
Public health strategies to prevent HIV transmission
•Screen all blood and blood products
•Follow universal precautions
•Educate in safer sex practices
•Identify and treat STIs/other infections
•Provide referral for treatment of drug dependence
•Apply the comprehensive PPTCT approach to prevent
vertical transmission of HIV
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17. Natural History of HIV Infection
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18. Natural History of HIV Infection
•Virus can be transmitted during each stage
• Seroconversion
•Infection with HIV, antibodies develop
• Asymptomatic
•No signs of HIV, immune system controls
virus production
• Symptomatic
•Physical signs of HIV infection, some
immune suppression
• AIDS
•Opportunistic infections, end-stage disease
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19. Natural History of HIV Infection
•Immune suppression
•HIV attacks white blood cells,called CD4
cells, that protect body from illness
•Over time, the body’s ability to fight
common infections is lost
•Opportunistic infections occur
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20. HIV Disease
•Progression of HIV disease is measured by:
•CD4+ count
•Degree of immune suppression
•Lower CD4+ count means decreasing immunity
•Viral load
•Amount of virus in the blood
•Higher viral load means more immune
suppression
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21. HIV Disease
•Severity of illness is determined
by amount of virus in the body
(increasing viral load) and the
degree of immune suppression
(decreasing CD4+ counts)
•Higher the viral load, the sooner
immune suppression occurs
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22. Progression of HIV Infection
•HIGH viral load (number of copies of HIV
in the blood)
•LOW CD4 count (type of white blood
cell)
•Increasing clinical symptoms (such as
opportunistic infections)
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23. HIV Disease
•Direct infection of organ systems
•HIV can directly infect the:
•Brain (HIV dementia)
•Gut (wasting)
•Heart (cardiomyopathy)
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24. HIV Disease: Summary
•HIV multiplies inside the CD4+ cells, destroying them
•As CD4+ cell count decreases and viral load increases, the immune defences are weakened
•HIV-infected people become vulnerable to opportunistic infections
•HIV is a chronic viral infection with no known cure
•Without ARV treatment, HIV progresses to symptomatic disease and AIDS
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25. Key Points
•HIV is a global pandemic and the number of people living with HIV continues to
increase worldwide.
•HIV epidemic is especially severe in resource-constrained settings
•HIV is a virus that destroys the immune system, leading to opportunistic
infections.
•The progression from initial infection with HIV to end-stage AIDS varies from
person to person and can take more than 10 years.
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26. Key Points (continued)
•The most common main route of transmission worldwide is
heterosexual transmission.
•Women of childbearing age are at particular risk for acquiring
HIV through unprotected sex
•HIV-positive women who are pregnant are at risk of passing
HIV infection to their newborn.
•Risk of HIV transmission from mother-to-child can be greatly
reduced through effective PMTCT programs
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